Q&A: The ins and outs of the Clinical Research Capabilities and Technologies Initiative

Today Chancellor of the Exchequer George Osborne announced the recipients of our Clinical Research Capabilities and Technologies Initiative, with 23 projects receiving a total of just over £170m. But what exactly are these ‘capabilities’, what do we hope to achieve, and where did all that money come from? Katherine Nightingale takes a closer look.

What do we mean by clinical research capabilities?

It’s about new technologies for clinical research. We’re all familiar with the idea of clinical research being about clinical trials to assess drugs, devices and diagnostics in people. Clinical research is often seen as the end of the ‘pipeline’ from making discoveries in the laboratory to helping patients, but that’s not the whole story.

We want to make clinical research in the UK also about studying disease at the molecular, cellular, organ and whole-body level ― and to do that researchers need new tools. This includes better body-imaging equipment, new technology for monitoring physiology, and ways of analysing the intricacies of disease in cells and tissues. Doing this needs big pieces of kit, as well as resources for building on the equipment in the future and using it in new ways.

Discoveries made in this way might then be fed back ‘into the lab’ or go on to influence further clinical research. The aim is that by funding these technologies, we’ll build on existing infrastructure, and speed up innovation by allowing researchers to explore new areas.

Could researchers apply for funding for any kind of kit?

We asked for applications in three main themes. The first of these was technologies for two fields which concentrate on studying disease in people rather than the petri dish: stratified medicine (which aims to tailor treatments for groups, or strata, of patients) and experimental medicine (research in people or patients to investigate how disease works). The second area was research into dementias, and the third theme was single-cell genomics, which studies cells and their interactions at an individual level, rather than many at once.

Universities with a medical school or NIHR Biomedical Research Centre or Biomedical Research Unit were invited to apply for funding. An international panel decided to fund 23 projects out of a potential 30 at a meeting in July.

So what kinds of projects have been funded?

The 23 projects will be based all over the UK. Examples include £13.7m to double the number of 7 tesla MRI scanners in the UK from two to four. Most MRI machines found in hospitals or research centre use electromagnetic fields of 1.5 or 3 tesla. These powerful new scanners, in Cardiff and Cambridge, will allow researchers to visualise the body with much more clarity.

Researchers will use the scanners to investigate the causes and progression of diseases such as schizophrenia, dementia, Parkinson’s disease, Huntington’s disease and multiple sclerosis, as well as assess how well new treatments work.

The Dementias Research Platform UK, a public-private partnership led by the MRC, has received £36.9m. A proportion of this will go towards combining an MRI scanner with a positron emission tomography (PET) scanner to visualise protein deposits in the brain. Some will be devoted to informatics and making large amounts of clinical data useful to researchers, while the remaining investment will be used to reprogram skin and blood cells to investigate how they change as dementia begins and progresses.

Other projects include a Clinical Proteomics Centre for Stratified Medicine at the University of Manchester, which will develop techniques to measure many proteins within a single sample (such as blood, urine, or from tissue such as a tumour biopsy) within a much shorter time than has ever been possible before. This will help to determine the differences between samples from healthy people and people with a specific disease.

At the University of Liverpool, researchers will study how to identify the best treatments for patients based on how they respond to drugs. They will do this using different “experimental” systems ranging from single cells to experimental studies in people, to careful clinical observation of patients.

The Institute of Cancer Research in London aims to improve the accuracy of radiation therapy by developing a new type of machine called an MR-Linac, which combines the latest radiation machine (called a linear accelerator) with an MRI scanner.

At Queen’s University in Belfast a new facility will be established for the testing of cell therapies in clinical trials for conditions including respiratory failure in the critically ill and vision loss. The centre will do everything from manufacturing to storing and preparing the cells for trials, and will be available for use by external universities, hospitals and companies.

Details of all the projects funded can be found on our website.

Where did the money come from?

The Department of Health contributed £150m of capital funding to the scheme from the ring-fenced health budget as part of the 2013 Spending Review. This is to fund projects in England which advance the department’s objectives.

The Welsh Government has contributed £4.1m for Welsh projects, and the MRC has added £14.8m from our forthcoming capital budget for applications outside England. The British Heart Foundation has contributed £1.5m, and Arthritis Research UK £650,000. The Northern Ireland Department of Health, Social Services and Public Safety has committed £750,000 in support of the project at Queen’s University Belfast.

Once you include all the money that universities will also add into project pots, around £230m will be invested in the projects.

What happens next?

This money will be spent between 1 April 2015 and 31 March 2016 to establish these technologies, and we’ll be following up to make sure that everything happens as planned. The facilities will be part of the national science base, with access not limited to researchers in the host institutions.

Although the Wellcome Trust, Cancer Research UK, Research Councils UK and the Scottish Government did not contribute funds directly, they were all involved with the overall governance of the initiative. They have endorsed the capital investments that have been made, and aim to provide further support through their own funding schemes to help embed and sustain the new infrastructure.